I understand you work in health but I work as a paramedic and have a few thoughts. First, it is very common for us to go into a scene with law enforcement and sedate someone if we believe it to be appropriate. Excessive fighting with law enforcement and being tased repeatedly tends to be followed by death. So, it is much easier and safer for everyone to sedate someone.
What protocols do you think will change? Should we just let people die fighting with law enforcement? I have mixed thoughts on the details here if we as paramedics can be prosecuted if someone has a negative reaction to a medication, however, I don’t think that is the case here. It says they gave an extra 150-200mg of ketamine, not sure why, not sure what their protocols are but if their dose is something like 5mg/kg IM like protocols I’ve worked under then maybe they thought it was an appropriate dose because we are bad at estimating weight. Regardless, it is industry standard to monitor capnography when sedating a patient. If they didn’t because of complacency, that might be on them if there isn’t any extenuating circumstance but I can’t think of any that would reasonably justify not monitoring capnography.
Lmao, I appreciate your concern because no that would not be appropriate in any way shape or form. However an EMT cannot administer sedatives. A paramedic can. One needs to have the 4 months of EMT school plus a minimum of one year of paramedic school, to be a paramedic. The program I teach at starting from no training through paramedic school is two years.
Additionally, I understand the general population doesn’t understand or is not exposed to what the capabilities of EMS is or how it works but id be happy to answer and explain any details that you’d like. But to start no, none of this happens without a physician. The physician is present in this situation in the form of protocols which are essentially a prescription that paramedics are authorized to follow without talking to a physician in real time.
But, I will agree I think the two years is a fairly small requirement for the invasive procedure and access to anesthesia medications that we as paramedics have and are authorized to use without having a doctor near us. It gets even crazier to think that I in my current roll am authorized to perform some emergency surgeries, such as cricothyrotomy and finger thoracostomy, as well surgically placing chest tubes and even perform a pericardiocentesis.
So sure it sounds bad from the outside if I say after one year of paramedic training I can cut a hole in someone’s chest on the side of the road to stick my finger in, or stab a needle into their heart, after I sedate then paralyze them, intentionally stopping their breathing just to place a breathing tube before putting them on a ventilator. That is stuff that all requires very specific training, any sort of surgery is generally only performed by doctors, paralytics and intubation is more specifically an emergency physician or anesthesiologist and ventilators are generally a respiratory therapist’s job. But that’s the beauty of paramedicine, we can do anything as long as we are acting in good faith trying to help someone. BUT systems that allow us to do pretty much anything I just listed are not “get hired out of school” programs. The minimum is generally 3 years as a paramedic in a busy system, but most require five years. In addition to the minimum experience, the extra skills are taught to us on the job by physicians, who individually validate that we are competent and capable to perform them. If the agency is associated with a hospital more often then not we will be required to work with our medical director and perform the skills on real patients before we are allowed to perform them on our own.
If you have any more questions or would like any more information just ask! I love my job and enjoy teaching others and advocating for the profession.